Provider Demographics
NPI:1891017109
Name:CHICAGO PROFESSIONAL HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:CHICAGO PROFESSIONAL HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-785-6860
Mailing Address - Street 1:1717 HOWARD ST STE A&B
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3735
Mailing Address - Country:US
Mailing Address - Phone:708-667-6604
Mailing Address - Fax:708-669-8255
Practice Address - Street 1:1717 HOWARD ST STE A&B
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3735
Practice Address - Country:US
Practice Address - Phone:708-667-6604
Practice Address - Fax:708-669-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-28
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health